On current occasion: Coronavirus and pregnancy - We are here for you without restrictions!
Corona has arrived in Germany: From a medical point of view, this was only a matter of time.
Pregnancy is a constantly evolving event, which does NOT allow for an EXTENSION in medical care at the various milestones of the unborn child's development: Against this background, I see it as my responsibility to offer you specialized prenatal medical health care without restriction, also and especially during this special time.
As a health care facility, we are subject to the current requirements or guidelines of the state government. These state (§ 28b para. 2 sentence 1 Infection Protection Act) that accompanying persons (visitors) are NOT allowed to enter the practice. Accompanying persons are then not considered visitors in the sense of § 28b para. 2 sentence 1 Infection Protection Act and therefore do not have to be tested, provided that the persons treated, cared for, nursed or accommodated are dependent on the accompanying persons in the context of their therapy, to promote the success of the treatment or in everyday life.
According to the current state of knowledge, corona is, of course, serious in terms of health for otherwise healthy, young people, but it is generally not (life-) threatening. The medical-scientific data, especially the epidemiological data of the Federal Statistical Office with the age-related monthly deaths in the German resident population, speak a very clear language in this regard: Most affected persons live through the infection with no (especially children) or only minor clinical symptoms.
In contrast, the following groups of people are at risk: Elderly people over 70 years of age, overweight people, immobilized, chronically bedridden and multiply ill people, people with pre-existing pulmonary and cardiovascular diseases (COPD (frequent in long-term smokers), chronic high blood pressure, diabetes). High blood pressure, diabetes), especially in the presence of a combination of these chronic health impairments. Also at risk are people with congenital (hereditary) as well as acquired metabolic or coagulation disorders and autoimmune diseases. Here, depending on the individual situation, the infection can be severe and possibly fatal. Incidentally, SARS-CoV-2 shares this general biological behavior with many other infectious respiratory diseases: According to the weekly updated data of the Working Group Influenza at the Robert Koch Institute, SARS-CoV-2 accounts for about 5-15% of the pathogens of clinically relevant respiratory diseases (ARE - Acute Respiratory Diseases), depending on the season.
As for overall mortality from or with COVID-19, data vary by definition (IFR - Infection fatality rate, CFR - Case fatality rate) and population sample studied. Averaged across all age groups, it ranges from 0.2 to 1% (Ioannidis 2020a, Luo 2021) and is 50-100x lower in countries with a high proportion of elderly in the under-65 group than in the over-65 group (Ioannidis 2020b). Thus, the imputed risk of a healthy person infected with Corona who is younger than 65 years of age to die from this disease ranges from 0.002% to 0.02% ( = range between 1:5000 and 1:50,000).
This finding is crucial for the individual risk assessment of pregnant women, since they initially belong to the group of people under 65 years of age. However, pregnant women are to be classified as a risk group because pregnancy itself leads to a general increase in susceptibility to infections and the body's regulatory systems are more susceptible to disruption during pregnancy (example: coagulation, glucose tolerance). This can be further influenced by other individual health characteristics (including body weight). This roughly results in a doubling of risk compared to non-pregnant women of the same health status (Jafari 2020).
In this respect, efforts aimed at slowing down the basically unavoidable spread of the virus to vulnerable populations such as the elderly and/or those with multiple illnesses make sense (AHA). A "prevention" of a corona infection (zero COVID), which is demanded or targeted by various parties, is biologically not possible with a highly infectious respiratory virus and therefore already conceptually and as "wording" health policy and regulatory mischief. However, until the general aim of infestation of the population, which is promoted by vaccination, is reached, the infection waves, which are also basically unavoidable, can be flattened and prolonged by AHA and vaccination: A vaccination or an infection that has been passed through means acquired antibodies against Corona and consequently a milder course in case of reinfection. In general, reinfections after vaccination are normal for viruses with a high potential for modification of their antigens (at this point Corona behaves similarly to influenza). In this respect, the expression "vaccine breakthrough" used in the media for corona infection after vaccination is medically misleading and thus not helpful.
The measures taken thus successfully prevented an acute overload of the healthcare system (scenario of more patients requiring ventilation than ventilation places), as impressively demonstrated by the total number of occupied intensive care beds recorded in the DIVI time series of intensive care occupancy in German hospitals since May 2020: This shows a constant level of 20,000 occupied beds since the beginning of the occurrence of SARS-CoV-2, practically unaffected by the corona waves, of which corona patients proportionally accounted for a maximum of 25% during the peaks of the respective waves. SARS-Cov2 respiratory infections have thus established themselves as a separate subgroup of acute infectious respiratory diseases in the spectrum of potentially severe respiratory diseases since their initial recording in 2019/2020 and will continue to accompany us like SARS-CoV1 since 2003 and MERS since 2012.
The knowledge about special risk assessment in pregnant women is growing visibly. You can find relevant information in the section "SARS-CoV 2" on the homepage of the RKI - Robert Koch Institute.